Abstract
Thrombocytosis (platelets ≥ 400K) is a common hematologic finding in gynecologic malignancies and associated with worse outcomes. Limited data exist on the prognostic capability of thrombocytosis in women with high-grade endometrial cancer (EC). Our objective was to describe the associations between elevated platelets at diagnosis, clinicopathologic features, and survival outcomes among women with high-grade, non-endometrioid EC. A review of the institutional cancer registry was performed to identify these women treated between 2005 and 2017. Sociodemographic, clinical, and outcomes data were collected. Analyses were performed using chi-square tests, Cox proportional hazards models, and the Kaplan–Meier method. A total of 271 women were included in the analysis. A total of 19.3% of women had thrombocytosis at diagnosis. Thrombocytosis was associated with reduced median overall survival (OS) compared with those not displaying thrombocytosis (29.4 months vs. 60 months, p < 0.01). This finding was most pronounced in uterine serous carcinoma (16.4 months with thrombocytosis vs. 34.4 months without, p < 0.01). While non-White women had shorter median OS for the whole cohort in the setting of thrombocytosis (29.4 months vs. 39.6 months, p < 0.01), among those with uterine serous carcinoma (USC), this finding was reversed, with decreased median OS in White women (22.1 vs. 16.4 months, p = 0.01). Thrombocytosis is concluded to have negative associations with OS and patient race.
Highlights
Endometrial cancer is the most common gynecologic malignancy in the United States [1].Pathologic features are used to categorize tumors into low- and high-grade subtypes, often described as types I and II, respectively [2]
estrogen receptor (ER) was positive in 56.1%, and progesterone receptor (PR) was positive in 42.9% of patients
While thrombocytosis has been previously studied in patients with endometrial cancer, this study provides the first look at a large cohort of patients with multiple type II histologies, with sub-analyses by race
Summary
Pathologic features are used to categorize tumors into low- and high-grade subtypes, often described as types I and II, respectively [2]. Type II tumors are typically hormone independent and impart a less than 60% 5 year overall survival [3,4]. Amongst the type II high-grade subtypes are several distinct, though rare, tumor histologies, including uterine serous carcinoma (USC), uterine clear cell carcinoma (CCC), and carcinosarcoma (CS) [5]. The incidence of type II endometrial cancer is increasing [6], for unclear reasons, with racial minorities disproportionately and negatively affected by these specific histologies in both incidence and survival outcomes [7,8]
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